title: Effect of statin use on outcomes of non-muscle-invasive bladder cancer.
abstract: OBJECTIVE
  To assess the impact of statin use on outcomes of patients with non-muscle-invasive bladder cancer (NMIBC). To measure the effect of statin use on the efficacy of intravesical bacillus Calmette-Guérin (BCG) therapy.
  
  
  METHODS
  A retrospective analysis was performed on 1117 patients treated with transurethral resection of the bladder (TURB) for NMIBC at three institutions between 1996 and 2007. Statin use at the time of diagnosis was recorded for each patient. Univariable Cox regression models addressed the association of statin use with disease recurrence, disease progression, cancer-specific mortality and overall mortality in all patients, patients with primary NMIBC, patients not treated with BCG, and patients treated with BCG.
  
  
  RESULTS
  Overall, 341 patients (30.5%) used statins and 776 (69.5%) did not. Within a median (interquartile range) follow-up of 62.7 (25.0-110.7) months, 469 patients (42.0%) experienced disease recurrence, 103 (9.2%) progression, 50 (4.5%) cancer-specific mortality, and 299 (26.8%) any-cause mortality. In univariable Cox regression analyses, statin use was not associated with any of these four endpoints (P > 0.05 for all). In subgroup analyses, statin use was also not associated with prognosis in patients with primary NMIBC or patients not receiving BCG (P > 0.05 for all four endpoints). Statin use was not associated with response to BCG (P > 0.05 for all four endpoints).
  
  
  CONCLUSIONS
  Statin users did not experience different outcomes compared with non-users and statin use did not affect the efficacy of BCG immunotherapy; these data do not support modification or discontinuation of statin therapy for patients with NMIBC.
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY 10065, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Crivelli
authors.forename: Evanguelos
authors.initials: E
authors.lastname: Xylinas
authors.forename: Luis A
authors.initials: LA
authors.lastname: Kluth
authors.forename: Rodrigo Donalisio
authors.initials: RD
authors.lastname: da Silva
authors.forename: James
authors.initials: J
authors.lastname: Chrystal
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
authors.forename: Scott G
authors.initials: SG
authors.lastname: David
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Scherr
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors